Management of intracerebral hemorrhage following TPA for ischemic stroke

If there are any effective reversal treatments there is no good evidence to guide their use according to a systematic review in JAMA Neurology.

A discussion of the paper in Medpage Today notes the need for better evidence. The discussion says guidelines address the problem of TPA related cerebral hemorrhage, though based on low level evidence and expert opinion. The piece links to the current guidelines for the management of ischemic stroke. Those guidelines, however, only briefly mention TPA related hemorrhage and for management of this complication refer the reader to these guidelines for management of cerebral hemorrhage. They in turn, however, do not specifically address TPA related hemorrhage though they do address head bleeds related to oral antithrombotic agents.